Performance of CytoDiff flow cytometry for determining blasts in peripheral blood

doi:10.3969/j.issn.1673-8640.2017.05.017

Abstract

Abstract:

Objective To investigate the performance of CytoDiff flow cytometry for determining blasts in peripheral blood. Methodse A total of 976 patients were enrolled in Hematology Department of Ruijin Hospital from April 2015 to March 2016. White blood cell （WBC） differentiation was performed by hematology analyzer,CytoDiff flow cytometry and morphology differentiation. The consistency was analyzed between hematology analyzer and CytoDiff flow cytometry with morphology differentiation as standard method. Results The average time required to analyze 20 samples was approximately 60 min for CytoDiff flow cytometry,and the manual operation time was about 15 min. The correlations of WBC differentiation were good among hematology analyzer,CytoDiff flow cytometry and morphology differentiation. The r was 0.959 between CytoDiff flow cytometry and morphology differentiation,and the r of neutrophils,lymphocytes,monocytes,eosinophils,basophils and immature granulocytes were 0.938,0.893,0.871,0.962,0.833 and 0.786. The r between hematology analyzer and morphology differentiation were 0.902,0.750,0.436,0.860,0.758 and 0.678,respectively. When >1% was set as the cut-off value of blasts on morphology differentiation,there were 235 positive cases among 976 samples,the hematology analyzer appeared "blasts" in 283 samples,and the sensitivity,specificity,positive predictive value and negative predictive value of hematology analyzer were 75.7%,85.8%,62.9% and 91.8%,respectively. When >1% was set as the cut-off value on CytoDiff flow cytometry,there were 239 positive cases,and the sensitivity,specificity,positive predictive value and negative predictive value of CytoDiff flow cytometry were 100.0%,99.5%,98.3% and 100.0%,respectively. Conclusions A cut-off value of 1% of blasts is recommended for CytoDiff flow cytometry,which is a sensitive,specific,accurate and rapid method for determining blasts. CytoDiff flow cytometry meets the demand of clinic for the early determination and the monitor of curative effects,and it has prospect in blast determination.

Key words: CytoDiff flow cytometry, Blasts, Morphology

CLC Number:

R446.1

GUO Ping, CHEN Liting, SONG Weixing, SHI Hourong, WANG Jianbiao. Performance of CytoDiff flow cytometry for determining blasts in peripheral blood[J]. Laboratory Medicine, 2017, 32(5): 421-426.

Figures/Tables 6

References 13

[1]	NOVIS D A,WALSH M,WILKINSON D,et al.Laboratory productivity and the rate of manual peripheral blood smear review: a college of American pathologists Q-probes study of 95 141 complete blood count determinations performed in 263 institutions[J]. Arch Pathol Lab Med,2006,130(5):596-601.
[2]	BARNES P W,MCFADDEN S L,MACHIN S J,et al.The international consensus group for hematology review:suggested criteria for action following automated CBC and WBC differential analysis[J]. Lab Hematol,2005,11(2):83-90.
[3]	Clinical and Laboratory Standards Institute. Reference leukocyte (WBC) differential count (proportional) and evaluation of instrumental methods[S]. H20-A2,CLSI,2007.
[4]	FUENTES-ARDERIU X,GARCIA-PANYELLA M,DOT-BACH D.Between-examiner reproducibility in manual differential leukocyte counting[J]. Accred Qual Assur,2007,12(12):643-645.
[5]	ROUSSEL M,BENARD C,LY-SUNNARAM B,et al.Refining the white blood cell differential: the first flow cytometry routine application[J]. Cytometry A,2010,77(6):552-563.
[6]	FAUCHER J L,LACRONIQUE-GAZAILLE C,FRéBET E,et al. "6 markers/5 colors" extended white blood cell differential by flow cytometry[J]. Cytometry A,2007,71(11): 934-944.
[7]	BJÖRNSSON S,WAHLSTRÖM S,NORSTRÖM E,et al. Total nucleated cell differential for blood and bone marrow using a single tube in a five-color flow cytometer[J]. Cytometry B Clin Cytom,2008,74(2):91-103.
[8]	CHERIAN S,LEVIN G,LO W Y,et al.Evaluation of an 8-color flow cytometric reference method for white blood cell differential enumeration[J]. Cytometry B Clin Cytom,2010,78(5):319-328.
[9]	刘雪凯,王建中,邢莹,等. 单管10色流式细胞术分类计数外周血白细胞[J]. 中华检验医学杂志,2011,34(5):395-402.
[10]	VAN DE GEIJN G J,VAN REES V,VAN PUL-BOM N,et al. Leukoflow: multiparameter extended white blood cell differentiation for routine analysis by flow cytometry[J]. Cytometry A,2011,79(9):694-706.
[11]	SHAFER J A.Blood and marrow morphology in acute leukemia patients receiving chemotherapy: a photo-essay[J]. Am J Med Technol,1983,49(2):77-90.
[12]	JO Y,KIM S H,KOH K,et al.Reliable,accurate determination of the leukocyte differential of leukopenic samples by using hematoflow method[J]. Korean J Lab Med,2011,31(3):131-137.
[13]	LACOMBE F,ARNOULET C,MAYNADIé M,et al.Early clearance of peripheral blasts measured by flow cytometry during the first week of AML induction therapy as a new independent prognostic factor:a GOELAMS study[J]. Leukemia,2009,23(2):350-357.

项目	快速流式细胞术与形态学计数		血液分析仪与形态学计数
项目	r值	P值	r值	P值
中性粒细胞	0.938	<0.001	0.902	<0.001
淋巴细胞	0.893	<0.001	0.750	<0.001
单核细胞	0.871	<0.001	0.436	<0.001
嗜酸性粒细胞	0.962	<0.001	0.860	<0.001
嗜碱性粒细胞	0.833	<0.001	0.758	<0.001
未成熟粒细胞	0.786	<0.001	0.678	<0.001
原始细胞	0.959	<0.001	-	-

项目	快速流式细胞术与形态学计数		血液分析仪与形态学计数
项目	r值	P值	r值	P值
中性粒细胞	0.938	<0.001	0.902	<0.001
淋巴细胞	0.893	<0.001	0.750	<0.001
单核细胞	0.871	<0.001	0.436	<0.001
嗜酸性粒细胞	0.962	<0.001	0.860	<0.001
嗜碱性粒细胞	0.833	<0.001	0.758	<0.001
未成熟粒细胞	0.786	<0.001	0.678	<0.001
原始细胞	0.959	<0.001	-	-

仪器报警	形态学计数
仪器报警	+	-
+	178	105
-	57	636
合计	235	741

仪器报警	形态学计数
仪器报警	+	-
+	178	105
-	57	636
合计	235	741

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